Youth Secure Care: The Politics of Forced Treatment

Posted By Lauren Hanon

It is common to hear parents say they would do anything for their kids. When it comes to a child’s life, ‘doing anything’ tends to be literal. It is this feeling of desperation felt by parents and guardians of children that motivates provincial legislation to enact youth secure care. When a child suffers from serious drug and alcohol abuse, parents or guardians know that the risks involved with such behavior are life threatening. In these circumstances, parents or guardians can seek a court order to have their child apprehended and forced into secure care for detox and treatment over a period of time approved by the court. Youth secure care is a provincial initiative, however. Not all provinces have the legislation that permits these programs.

In Alberta, there is the Protection of Children Abusing Drugs Act, the Protection of Sexually Exploited Children Act, and the Child, Youth and Family Enhancement Act; Saskatchewan has the Youth Drug Detoxification and Stabilization Act; Manitoba has the Youth Drug Stabilization (Support for Parents) Act; Ontario has the Child and Family Services Act; Quebec has the Youth Protection Act; New Brunswick has the Family Services Act; and Nova Scotia has secure care provisions within the Children and Family Services Act. In all of these Acts, there are varying areas of entry for youth. For example, while legislation may allow the parents to seek a court order to have their child apprehended according to one Act, in another province, a child who is already accessing other social services may find a different way into secure care. More specifically, a parent may obtain a court order in Alberta for their child whereas in British Columbia, a child may only find their way into secure care through the criminal justice system. The territories, British Columbia, Newfoundland and Labrador, and Prince Edward Island do not have any legislative provisions allowing youth to be taken into secure care for detox and treatment against their will. British Columbia had a Secure Care Act that never came into effect for political reasons in 2001. However, the province now seems ready to take another look into the issue.

Many factors contribute to the presence or absence of youth secure care legislation in a province or territory. Notably, it appears politics plays a large role, as is evidenced in British Columbia. I had the opportunity to talk to Dr. Grant Charles, a professor at the University of British Columbia in the School of Social Work, about this issue. In the paragraphs that follow, the information that I present is largely derived from my conversation with Dr. Charles. I have done my best to reproduce and paraphrase what Dr. Charles has shared with me.

Youth secure care is a sensitive issue politically because it involves individual people’s liberties. Secure care and forced treatment for an adult violates their civil liberties, which are protected by the Canadian Charter of Rights and Freedoms. If legislation violates a person’s Charter rights, the violation must be “subject only to such reasonable limits prescribed by law as can be demonstrably justified in a free and democratic society,” according to section 1 of the Charter. In other words, there has to be a really good reason for a Charter violation to be justified. In the case of youth secure care, we are talking about minors. We have many legal restrictions on what minors can and cannot decide for themselves, but when it comes to parents or guardians deciding whether their child needs to be forced into treatment programs, it seems a little less comfortable to assert that a youth does not have any right or a say in the matter.

Depending on whom you talk to, the goals may differ for the various programs. What a government looks for in implementing secure care legislation is effective drug treatments for minors that work to rebuild families and ensure that the youth patient overcomes his or her drug abuse. For parents, the most they might hope for is for their child to stay alive. What health care professionals and social service workers that run the programs hope for could differ as well. Therefore, asking “do these kinds of programs work?” is a difficult and complex question and the answer will vary depending on what ‘working’ means. For these reasons, it can be difficult politically to talk about the issue of youth secure care seeing as there is so much emphasis put on individual rights and where there are so many stakeholders.

Another factor that complicates the enactment of such legislation is the lack of studies on existing youth secure care programs. Indeed, what would such a study even look like? Which factors would be assessed, what standards would be used to determine if the legislation is working as intended? Given that most youth secure care programs are short term, ranging from a 10-day immediate detox to extended stays, all varying between provinces, the outcomes from patients can only be measured in the short term. Long-term outcomes would be much more difficult to assess as it would involve extensive monitoring. Many programs currently in existence will have their own internal monitoring, methods of assessment, records and statistics, but this information is not publicly available. For evidence-based policy decisions in provinces that do not have youth secure care, the lack of studies and statistics from other provinces’ programs is discouraging.

According to Dr. Charles, we need to understand and appreciate the issues surrounding youth drug and alcohol abuse (and other dangerous and risky behavior) as family and community issues. Re-centering the focus from an individual’s rights perspective to one that puts more value on family and community rights will result in a more accurate grasp of the reality of these kinds of programs. The problems and challenges that a child engaged in extremely dangerous behavior faces are not in a vacuum. Everyone in that child’s life is affected. Dr. Charles suggests that the real outcome of youth secure care is that it gives the child and the parents or guardians a “break”. The short period of the program allows the parents to have some time to rest knowing that their child is safe. This breather ‘reboots’ the natural strengths and support systems that were previously exhausted and presumably at a point of ineffectiveness. The child becomes stabilized and the family has another chance to move forward.

In the provinces where youth secure care legislation does not exist, mental health institutionalization and the youth criminal justice system tends to fill in the gaps where other social and health services fail, according to Dr. Charles. However, youth who go through these systems tend not to receive the care and support that they need to move forward positively in their lives. Youth secure care programs are a necessary part of family and community values that are missing from other governmental means to address challenges that are faced by youth engaging in dangerous and risky behavior. A report released last year by the Representative for Children and Youth in British Columbia titled Paige’s Story documents the heartbreaking life of a teenage girl named Paige and her death at the age of 19. The report claims that her death was the result of the “institutional indifference,” where the governmental agencies and foster families and the youth criminal justice system failed Paige at every step of her life. One of the recommendations of the Report is for the Ministry of Children and Family Development to “explore the creation of a form of secure care” that would allow for the apprehension of vulnerable children to remove them from situations that are unacceptably dangerous.

It is of the utmost importance that provinces and territories that do not currently have secure care legislation move towards enacting it as soon as possible. It is not a perfect solution to the harms of youth drug and alcohol abuse, but secure care would go a long way in mitigating many of the tragic and avoidable circumstances that happened to Paige. According to Dr. Charles, the vast majority of youth that he saw going through secure care programs were extremely grateful for such interventions and were glad that they had the opportunities for treatment and regenerating family and community ties. Secure care is needed to move towards better care for youth in the hopes of making sure that “institutional indifference” will not fail another child like it did for Paige.